Envision Launches Video to Set the Record Straight on Surprise Coverage

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10.03.2018 -

NASHVILLE, Tenn. – Envision Healthcare, a leading provider of physician services, has launched a digital video campaign to inform patients about why surprise coverage is leaving them with unexpected medical bills, and how doctors and legislators can work together to address the problem and put patients first.

“As one of America’s largest physician groups, Envision clinicians share the frustration our patients experience due to surprise coverage,” said Christopher A. Holden, President and Chief Executive Officer of Envision. “Patients should focus on getting better, not worrying about unexpected bills resulting from surprise coverage and gaps in health insurance.”

“Surprise billing” is the catch phrase the media uses to describe bills patients receive from out-of- network hospitals or physicians. But that that label doesn’t capture the larger issue of “surprise coverage” that has been created by the steady fraying of the insurance safety net. The video explains how the proliferation of high deductible health plans, narrow networks with a limited number of hospitals and doctors, and outright care denials have combined to create surprises for patients.

A new Kaiser Health Tracking Poll found that unexpected medical bills tops the list of household financial concerns for nearly seven in 10 adults. Meanwhile, a new survey from NORC at the University of Chicago found that nearly six in 10 adults have been surprised by a medical bill that they thought insurance would have covered.

“Patients deserve more and better information from insurance companies and Envision is working with Congress to make sure they get it,” said Rebecca Parker, M.D., FACEP, Senior Vice President, Advocacy and Leadership. Dr. Parker is a past president of the American College of Emergency Physicians (ACEP) and a practicing attending emergency physician.

Envision Healthcare supports legislative solutions that would provide greater clarity on both the cost and content of emergency medical procedures that are often the subject of surprise coverage. Such transparency would empower patients and prevent insurance companies from hiding behind vague definitions of coverage in order to escape blame for surprise medical bills.

Such legislative solutions include:

Minimum Benefit Standard: A minimum benefit standard for unanticipated out-of-network emergency health care services should be established. Insurance companies must be required to reimburse the health care professionals at that standard. One way of determining the standard is to use the usual and customary rate defined as the 80th percentile of all charges for the particular health care service performed by a health care professional in the same or similar specialty and provided in the same geographical area as reported in the independent benchmarking database.

Uniform Method to Calculate Charges and Independent Database: Congress should establish a uniform method to determine usual, customary and reasonable (UCR) payments. UCR is the amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. Furthermore, policy makers need to establish a fair and independent charge database. The data must be verifiable and maintained by a non-profit organization that does not have any conflict of interest or connection to either providers or insurers.

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About Envision Healthcare Corporation
Envision Healthcare Corporation is a leading provider of physician-led services and post-acute care, and ambulatory surgery services. The Company delivers physician services, primarily in the areas of emergency department and hospitalist services, anesthesiology services, radiology/tele-radiology services, and children’s services to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a market leader in ambulatory surgical care, the Company owns and operates 261 surgery centers and one surgical hospital in 35 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopedics. In total, the Company offers a differentiated suite of clinical solutions on a national scale, creating value for health systems, payors, providers and patients. For additional information, visit www.evhc.net.